WAL-MART STORES EAST, LP
NPI: 1841373370
· FREDERICK, MD 21701
· 156FX1800X
$169K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,002 |
$12K |
| 2021 |
2,277 |
$33K |
| 2022 |
1,899 |
$30K |
| 2023 |
2,836 |
$54K |
| 2024 |
1,821 |
$39K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,544 |
3,352 |
$95K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,299 |
2,132 |
$31K |
| S0621 |
Routine ophthalmological exa |
630 |
614 |
$17K |
| S0620 |
Routine ophthalmological exa |
570 |
549 |
$15K |
| V2100 |
Lens spher single plano 4.00 |
481 |
448 |
$7K |
| V2784 |
Lens polycarb or equal |
1,097 |
1,006 |
$2K |
| V2521 |
Cntct lens hydrophilic toric |
12 |
12 |
$717.28 |
| V2750 |
Anti-reflective coating |
1,134 |
1,057 |
$518.00 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
13 |
13 |
$388.00 |
| V2025 |
Eyeglasses delux frames |
41 |
41 |
$280.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
14 |
14 |
$127.00 |